[The role of the preoperative radiochemotherapy and the role of neoadjuvant chemotherapy before radical Wertheim-Meigs hysterectomy for cervical cancer stage I B - II B].

One of the most important prognostic factors for early stages cervical cancers is the tumour size. The patients with size of the tumour bigger than 4 sm in diameter have worse prognosis. The aim of our research work was to compare the efficacy of preoperative radiochemotherapy and neoadjuvant intravenous chemotherapy, followed by radical hysterectomy a modo Wertheim-Meigs for stage I B - II B cervical cancer. We summerized our and foreign experience in this field. From 1998 till 2005 we examined 123 patients in stage I B - II B cervical cancer treated by preoperative percutaneous radiotherapy (dosis 45 Gy) plus cisplatin (50 mg/m2) compared with preoperative chemotherapy cisplatin (50 mg/m2), vincristin 1 mg/m2 every 7-10 days for 3 courses. Radical hysterectomy a modo Wertheim-Meigs was performed 4-5 weeks after the preoperative treatment. There is no significant difference in the age groups, stages of the tumour, the tumour size end the histopathological kind of the tumour between the 2 groups of examined patients. The toxicity in the two groups was mild. In the group with preoperative radiochemotherapy 4 patients developed vesicovaginal fistulas, 3 patients hydronephrosis. After the surgical treatment the invasion of the tumour in the parametrial region and the lymph nodes was without any significant difference between the two groups (p>0.06). In the group with neoadjuvant chemotherapy more patients had a residual tumour, but about the size of the tumours in the two groups there was no significant difference (p>0.05). The final pathological response was higher in the group received radiochemotherapy. Acording to the results of our research work the neoadjuvant chemotherapy and the radiochemotherapy have nearly equal effect on the prognostic factors connected with survival.